3) Put the swab in transport container or innoculate on dermatophyte test medium.

26Tine CapitisTreatment

Topical treatment is not effective.

Griseofulvine 20 to 25 mg/kg/day of microsize formulation for 6 to 8 weeks. Two weeks following resolution of symptoms.Relative resistance has been noted requiring high dosing.M.Canis is resistant to treatment and may require treatment for months.

27Tinea CapitisTreatment

Sporicidal shampoo such as 2.5 selenium sulfide or Ketoconazole should be used twice a week to reduce infectious risk, for 2 weeks.

Re-evaluate after 4 weeks of treatment and reculture at the end of treatment .

Family members and close contacts may receive topical treatment.

28Tinea CapitisTreatment

Careful hygiene-combs, brushes, headgear should not be shared.

Other oral anti-fungal for patients who do not tolerate or respond to Griseofulvin. Terbinafin (Lamisil) 3 to 6mg/kg once a day for 2 to 4 weeks. lt 20kg63.5mg/day,20 to 40 kg 125mg/day.gt40 mg250 mg/day.

29Tinea CapitisTreatment

Fluconazol 6mg/kg/day once daily for 6wk

Itraconazole 5mg/kg/day,once daily or divided into two doses,for 2 to 4 weeks continuous dosing, or pulse dosing(1 week of therapy a month for 1-3 pulses as clinically indicated)

Not approved by FDA for tinea capitis.

30Tinea CapitisTreatment

Indication for steroids. Lack of response after two weeks of anti-fungal treatment. Prednisone 1 to 2 mg/kg once daily for 10 to 14 days.

Distribution most common area is trunk, sometimes face forehead, and temple. Rarely arms, neck and axila.

Common in healthy adolescence.

60Tinea Versicolor

Pityrosporum folliculitis.

Cathetor related infections.

Seborrhea.

Flares of atopic dermatitis and neonatal cephalic pustulosis.

61Tinea VersicolarDifferential Diagnosis

Pityriasis alba.

Vitiligo.

Pityriasis rosea.

Seborrheic dermatitis.

62Tinea VersicolorDiagnosis

KOH preparation shows, short hyphae and spores(macaroni and meatballs).

Culture is not helpful since organism is a normal commensal.

63Tinea VersicolorTreatment

Ketoconazole shampoo for 3 to 5 minutes for three consecutive days.

Systemic treatment for extensive or recurrent disease.

Itraconazole, Ketoconazole, and Fluconazole are effective.

Terbinafin spray (Griseofulvin and turbinafin oral not effective).

64Tinea Pedis Complication

Chronic paronychia may be fungal infection of chronic dermatitis.

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